Hello, I've had a problem for the last 6-8 years or so which I've yet to get addressed. In 2013 I developed severe back pain from the top to the bottom of the spine. Spasms in back muscles only, and fasciculations, parasthesias and pain in both arms and both legs as well as pectorals and latissimus dorsi. Fasciculations also in sternocleidomastoid muscles, chin, eye and trapezius (i.e. cranial nerves). Parasthesias yes, but no actual complete numbness anywhere. Also some parasthesias at the time in the genital region. Sensation is preserved everywhere to light touch and pinprick, except that light touch causes pain in the hands. My operative assumption at the time was that this was a back problem. Brain MRI showed nothing of note. Full spine MRI done in 2015 showed mild degenerative changes which were age-appropriate, but no compression which would explain these problems, and no myopathy. No significant central stenosis, only mild foraminal stenosis in a few sites, and no listhesis on dynamic flexion or extension views. A neurologist and three back specialists confirmed that in their opinion this could not be caused by the back. I became almost bed bound for about 4 months, wheelchair bound for a year, and have never regained my strength since then. GBS was suggested at the time, but no spinal tap was done. NCS/EMG in 2015 showed essentially normal NCS with some minor low motor response on the right peroneal nerve, but everything else normal. Needle EMG on the other hand showed multilevel chronic radiculopathy at virtually every site tested, cervical levels and left L4-L5 (only the left side of my body was tested). Left First Digital Interosseous showed decreased motor units. My hands and forearms are weak and a mildly atrophied, the left worse than the right. The muscles between my fingers are somewhat atrophied, left worse than right. I do NOT have the split hand sign, as both sides of my palm muscles seem to be affected. Heelwalking on my left foot causes a mild foot drop. These areas are consistent with the findings on the EMG. I did have one spine doctor suggest thoracic outlet syndrome as I have diminished pulses and numbness when raising the arms above the head, as well as elongated transverse processes on my C7 vertebra. But this does not account for the overall weakness, failure to recover fully after 5 years, or the fasciculations, weakness and parasthesias in other parts of the body. Things seem to have a waxing and waning pattern, getting somewhat better for 6 months, and then getting worse, etc. Reflexes in arms are diminished, reflexes in knees are absent. Babinski sign and Hoffman sign are both normal. With the exception of my spine muscles, the muscles in the rest of my body are not spastic, but are instead kind of flaccid, especially in my arms. I do have esophageal spams which cause difficultly swallowing sometimes, but at other times not. So technically I have difficulty swallowing, but since it is not constant I think this is a red herring and attributable to the esophageal spasms. My tongue is normal size and does not seem to be atrophied. I have not been able to detect any abnormal movements in my tongue when looking at it in the mirror. My ability to stand is limited to about two 20-30 minute time periods during the day with many shorter walks to kitchen or bathroom. Total time on my feet is about 1 – 1 ½ hours per day. Total out of bed time is about 3-4 hours per day. I drive short distances and use the scooter at the grocery store. Morning activity makes me profoundly fatigued and takes many hours to recover from. It seems that after 6 years I should have recovered more, and simple “deconditioning” does not seem to fully explain what is going on. Workups for Lupus and Rhuematoid arthitis were negative. Total cholesterol is 140, LDH =90 and HDL = 30. These seems to be genetically low, since I have never taken any meds to get them like this and they have always been this low, regardless of what I ear. Testosterone is low. Problems: Morbid Obesity 330lbs, hypertension, Mild LVH (1mm), SVT, Gerd, prediabetes, Factor V Leiden. Meds=carvedilol, amlodipine, benadryl, ranitidine, pantoprazole, valerian, lorazepam approx 1-2 times per week, vitamin d, fish oil, vitamin b12 (blood levels are normal now but may have been slightly low before). QUESTION: what is the differential diagnosis for this pattern of weakness, fasciculations, parasthesias, and EMG changes? I need some avenues to pursue, since I've not gotten any real answers from my existing medical team.